Rao Jingjing, Zhu Qingling, Yang Xuejiao
Department of Laboratory, Shiyan Maternal and Child Health Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China.
Department of Internal Medicine, Yicheng Hospital of Traditional Chinese Medicine, Xiangyang, Hubei, P.R. China.
SAGE Open Med Case Rep. 2023 Oct 16;11:2050313X231206031. doi: 10.1177/2050313X231206031. eCollection 2023.
Liposarcoma is a carcinomatous mesenchymal tumor with various histologic features and is the most common soft tissue sarcoma originating in adipose tissue. Liposarcoma commonly occurs in the lower extremities and retroperitoneum but rarely in the mediastinum, specially extending into the thoracic cavity. We report a giant primary liposarcoma of the posterior mediastinum in a 63-year-old female who complained of cough, sputum, and pain in the right chest wall. A computed tomography scan of the chest showed a giant mass of 24 × 15 × 24 cm in the posterior mediastinum of the right thoracic cavity. After a thorough examination, no suspected lipomatous lesions were found elsewhere in the patient's body. The patient underwent a thoracotomy to remove the mediastinal mass through a right thoracic approach. Subsequently, hematoxylin-eosin staining revealed dedifferentiated liposarcoma (DDL), immunohistochemistry showed positive expression of cyclin-dependent kinase 4, and murine double minute 2 (MDM2), in addition, fluorescence hybridization for the MDM2 gene was also positive, which suggested DDL. The patient was discharged without any complications, and no metastasis or recurrence was observed after 19 months of follow-up. To provide a reference for clinical diagnosis and treatment, we reviewed and discussed the literature on primary liposarcoma of the mediastinum.
脂肪肉瘤是一种具有多种组织学特征的癌性间叶组织肿瘤，是起源于脂肪组织的最常见软组织肉瘤。脂肪肉瘤常见于下肢和腹膜后，但很少发生于纵隔，特别是延伸至胸腔。我们报告一例63岁女性后纵隔巨大原发性脂肪肉瘤，患者主诉咳嗽、咳痰及右胸壁疼痛。胸部计算机断层扫描显示右胸腔后纵隔有一个24×15×24 cm的巨大肿块。经过全面检查，在患者身体其他部位未发现可疑脂肪瘤样病变。患者接受了开胸手术，通过右胸入路切除纵隔肿块。随后，苏木精-伊红染色显示为去分化脂肪肉瘤（DDL），免疫组化显示细胞周期蛋白依赖性激酶4和鼠双微体2（MDM2）呈阳性表达，此外，MDM2基因荧光杂交也呈阳性，提示为DDL。患者无任何并发症出院，随访19个月未观察到转移或复发。为提供临床诊断和治疗参考，我们回顾并讨论了纵隔原发性脂肪肉瘤的文献。
